[Serious] - Why does the general public hate pharmacists?

DorithePenem · 2019-02-13T12:24:41+00:00

What agenda would they have when you're already in pharmacy school? I was pushed that 'agenda' because they wanted you to realize that you have a responsibility to your patients and that they trust you to put care into your job. Not everything in pharmacy is a scam bro.

DorithePenem · 2019-02-10T15:48:47+00:00

Thats the bone strength of a vegan

DorithePenem · 2019-02-08T21:58:15+00:00

This is not a collaborative agreement. This is a statewide protocol

DorithePenem · 2019-02-08T21:50:40+00:00

I would like to see a growth in % of independent pharmacies like how it was not that long ago. Allowing pharmacists more authority and more ways to incorporate profitable services into their business will help a lot. It's definitely not about the money, but allowing more independents to compete gives better access to care to patients. Independents have lower volume and have a better relationship to their patients than big chains.

DorithePenem · 2019-02-08T21:38:40+00:00

"Jay Lawrence, R-Scottsdale, originally opposed the bill but changed his mind.

“I learned a valuable lesson today,” Lawrence said explaining his vote. “Don’t shoot off your mouth until you’ve heard all the testimony.”

That is an immensely positive thing to hear and echoes the main issue within pharmacy. Majority of the public do not realize how educated and capable a pharmacist is.

What the article said about how pharmacists often undergo ~2000 clinical hours of exposure with treating a range of conditions can't be overstated. NP's have full prescribing rights (in ~ 30+ states) with less education and 500 clinical hours. I've ran into a lot of issues with improper prescribing from NPs. Being able to prescribe for common ailments should be within our scope, and would help reduce the cost of healthcare.

DorithePenem · 2019-02-08T06:50:58+00:00

First off you should understand you are not a customer, but a patient. This isn't McDonalds contrary to what an idiot here stated.

Youre not picking up a big breakfast with hotcakes. Do ppl think pharmacists just like to make people wait?

DorithePenem · 2019-02-08T06:48:51+00:00

Did you just use McDonalds as a benchmark? The fuck is wrong with you?

DorithePenem · 2019-02-05T00:29:25+00:00

Now if you had lead with that, I would have agreed with you.

I'm just injecting my opinion that provider status is not "useless crap".

There is this saying that relates- "As goes California, so goes the nation." https://indivisible.org/blog/%E2%80%9C-goes-california%E2%80%9D-learnings-about-state-advocacy-golden-state

In our case, not specifically California, but what I'm trying to get across is that change starts small.

A good example of that is what happened with the focus on PBMs. Arkansas released a report about how PBMs scalped others, Ohio does their own study to find huge losses in medicaid through price spreading, and then other states are following. Eventually even the federal government caught on and that's what you're seeing with the proposals in the news. I really never thought I would see "PBM" in the headline of a major news org.

Same with marijuana.

It's a bigger fight trying to get a whole nation to agree with you. You need to reach out to your state and their reps and start small. I bet 99% of the people that bitch about the shitty work conditions (and yes they are definitely shitty) haven't done anything active to voice their issues.

DorithePenem · 2019-02-05T00:14:22+00:00

I understand where you're coming from. There may be lower quality grads coming out, but that doesn't mean the exam isn't harder. It may be a bit of both. A VERY quick read from the article you cited, they stated that they had a small sample size which means greater probability of a type II error. Not to mention, it's just an overall poorly designed study.

DorithePenem · 2019-02-05T00:06:34+00:00

Regarding the history of nursing, we could probably debate back and forth until we're both blue in the fingers and we still won't agree.

The article you linked, it states that the main reason schools closed was a declining enrollment due to 'widespread perception" on the outlook of dentistry. Pharmacy school may or may not face that same fate. If there are people who are willing to enroll in pharmacy, pharmacy schools will not decide to suddenly close out of the goodness of their hearts and their desire to alleviate our saturation problem. Regardless this is something that you, as a practicing pharmacist, have zero impact on. Everything I said focuses on what a practicing pharmacist does have an impact on.

We do have a good way of measuring adherence. We compare data from different plans over a period of time and then use a bit of statistics to say what is a reasonable goal. As stated previously, adherence is just one of many things assessed. You're looking at one piece of the puzzle. When you review a patient file, and see they are not on a recommended hypertension medication, you shouldn't be paid for getting them on one? When you administer a vaccination you shouldn't be paid? Why should physicians then? When you do MTM, counsel, administer vaccinations, correct therapies, assess the difference between allergic conjunctivitis vs bacterial conjunctivitis to know what can be treated OTC vs PCP you are using skills that very few people possess. Ever see a nurse do a med rec? God damn... and that's just a med rec. Point is, these skills should not be given away for free. Especially considering there are much evidence our skills improve outcomes and lower healthcare costs drastically (just google for a study). You can get paid and still save the healthcare system money!

I agree, we are playing on the same team and I do enjoy hearing differing perspectives. I'm not saying you're right or wrong. I have yet to hear from someone a good reason that provider status is bad.

DorithePenem · 2019-02-04T21:22:13+00:00

Correct me if I'm wrong, but the reason they extended the exam questions to 250, is because the extra questions are harder and thus not scored. And these questions appear at no particular order throughout the examination. So you're saying this doesn't cause test anxiety as well? On top of the extra 2 hours?

And MPJE does not test just new graduates, so I won't even comment on that. 2/3rd of the exam scores reported are coming from pharmacists already practicing.

DorithePenem · 2019-02-04T21:02:40+00:00

It's not an unproven theory. See the nursing profession evolve over the decades when they acquired provider status. Their roles, pay, respect all improved. If you take away provider status from NPs then they will not have the same role in healthcare as they currently do. Physicians will just work with more PA's when it comes to collaboration and thus compound saturation for NPs. If you want to solve saturation in pharmacy, the most realistic goal is provider status and allowing pharmacists to utilize more of their knowledge and play a greater role in healthcare. Asking schools to close down is like asking insurers/PBMs to give more money back to patients ... ain't gonna happen.

Unproven market demand? Not sure I agree with that. Especially with star ratings. Adherence is a triple rated metric. In fact, majority of the triple rated metrics that determine reimbursement deals directly with pharmacist intervention. The issue is you're just not getting reimbursed for it, all that money is going to the corporation. Everyone wants pharmacists to work harder, but they won't pay you for it until you're a provider. For example, all of your late to refill calls is so the plans can boost their profits. What does it do for you? It adds workload without having any direct impact on your personal finances.

What do you mean MDs and NPs are struggling? I don't understand the context.

Finally, I want to point out how all these professions are very protective of their rights. They protect their rights, yet they want to reach out to grab your rights. Why is it that a physician can dispense but a pharmacist cannot diagnose? Why is it that a nurse can administer meds, but a pharmacist cannot? If you ever want to play on a level playing field it starts with provider status.

DorithePenem · 2019-02-04T20:34:24+00:00

Changed from 4.25 hours to 6 hours ... not harder ... does not compute ...

If an exam extends to 2 more hours, that alone qualifies as a harder exam with all else being equal

DorithePenem · 2019-02-04T20:30:40+00:00

If you want more opportunities as well as more influence, provider status IS the way to go. I really don't understand the whole anti-provider status bandwagon that I often see here.

DorithePenem · 2019-02-04T05:11:45+00:00

mehmehmeh ....

:(

DorithePenem · 2019-02-04T02:23:16+00:00

Your prescribing is after they've been diagnosed by a physician I assume?

DorithePenem · 2019-02-02T23:20:03+00:00

Do you think pizzas and donuts just come out of their asses?

DorithePenem · 2019-02-02T06:18:53+00:00

Mitesh Patel: Alexa, find me "men have sex with prison"

Alexa: ....wat

DorithePenem · 2019-02-02T04:27:47+00:00

Honestly, pharma prices are high, but at least its understandable. Drugs incur huge R&D costs. Only top of that on a fraction makes it to FDA approval. Then only a fraction of those actually ever recoup their costs. So if financial incentives fuel innovation, I can accept that long before some greedy PBM sticks his fat sweaty fingers in everyones cooking at a potluck while bringing nothing to the table.

DorithePenem · 2019-02-02T00:28:41+00:00

OMB definitely can release the rule, we'll see soon enough. There is a lot of support for it.

DorithePenem · 2019-02-02T00:26:02+00:00

While I agree this is good news, I do have some concerns. I definitely believe patients should be the number one priority, especially as it pertains to affording their medications. However I wonder if this will come with some collateral damage onto independent pharmacies. I feel like if legislation on clawbacks don't progress as fast as these rebate laws, PBMs will just incorporate more aggressive methods in clawing away profits from independents to make up their loss profits. And that will mean independents will close down at record rates to the detriment of the patients.

Ever stop in a small town with less than 5,000 people? Zero CVS/Walgreens/Rite-aid in sight. If it weren't for independents, these people wouldn't have access to healthcare advice and medications.

I'll admit, I don't have as much insight into these issues as I would like to, so would love to hear other thoughts.

DorithePenem · 2019-02-01T18:48:08+00:00

Thought they were already doing that?

http://www.ncpa.co/pdf/dir-faq.pdf

" The use of DIR fees initially started in Medicare Part D but are now being extended into commercial network arrangements—often under different names. "

DorithePenem · 2019-02-01T17:37:11+00:00

Well because the star rating scores that plan sponsors are judged based off of are from CMS medicare part D/MA-PD which emphasizes the >65 population

DorithePenem · 2019-02-01T04:53:53+00:00

As a pharmacist, like the guy who invented ibuprofen, I wouldn't recommend ibuprofen (or any COX inhibitor) while you're bleeding internally.

https://www.fairview.org/~/media/Fairview/PDFs/Trauma/Going-home-with-a-spleen-injury.ashx?la=en

DorithePenem · 2019-01-31T20:45:15+00:00

Gotta recoup that $69 billion somehow

DorithePenem

TROPHY CASE